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Book Review: Post-traumatic stress disorder. Krippner & Davies

Book Review:

Reviewed by Selene Kumin Vega, Ph.D. (Psychology), 2009

Trauma is often associated with violence, either from war, personal attacks, or abuse, but it can just as easily be a result of unpredictable and seriously disruptive forces of nature (hurricanes, earthquakes, or floods, for example). Traumatic events may be the extreme end of the spectrum of experiences of change that occur throughout our lives. Although the diagnosis of post-traumatic stress disorder (PTSD) is relatively recent (it was developed in the late 1970s as veterans returned home from Vietnam, often with emotional difficulties), the phenomenon of symptoms occurring following exposure to an extremely difficult events has been described in religious texts, literature, and diaries and memoirs.

The experience of a traumatic event does not necessarily lead to post traumatic stress disorder. Just as “stress” is a name for what we might experience in response to challenging situations outside of ourselves, the word “trauma” describes the wound or injury inflicted by an external event or situation. How each individual responds to those events and situations determines the intensity of the trauma experienced. As Krippner, Pitchford, and Davies emphasize,

How people experience their wounding brought on by a traumatizing event is strongly related to their person temperament, personal history (especially any prior traumas), context (the setting or environment,) and the subjective impact of the event—in other words, how they attribute meaning to what has happened. (p. 2)

The authors make the point that PTSD symptoms may be present even without what would usually be considered a traumatizing event. The continuum of distress from what we might call stress to what we understand as trauma includes responses to work-related and marital conflicts on one end, and war, violent abuse and attacks, and natural disasters on the other. The factors involved in “predisposing, activating, and maintaining” (p. 133) the symptoms of PTSD are complex and non-linear.

Krippner, Pitchford, and Davies have written this contribution to the Biographies of Disease series to provide a foundation for understanding PTSD. Rather than a treatment manual, this is an overview, covering differential diagnosis, the wide variety of manifestations of this complex phenomenon, PTSD in children and adolescents, the neuroscience underlying the symptoms, and the varied treatments available. The book achieves this goal, though it would have benefited from proofreading and editing. The first few chapters were somewhat repetitive, and there were a few slips where a different name was used to refer to one of the four case history subjects. The chapter on treatment approaches is fairly comprehensive and helpful at illustrating the wide variety of healing modalities used to address PTSD, though I was surprised to find no mention of body-oriented and somatic psychotherapy techniques such as Peter Levine’s Somatic Experiencing.

Perhaps the most inspiring part of the book is the last chapter, focusing on the post-traumatic strengths that may develop through the process of journeying through PTSD. The authors make the point that for a surprising number of PTSD survivors, finding their way through their difficult response to a traumatic event can lead to going beyond their former baseline normal state of being. These people find strength and meaning that had not been part of their lives before their traumatic experience. In the process of healing, they were able to “mine the gold” of their experience and grow, returning to the world with gifts of newfound strength, compassion, courage, and resilience.